Although some recognition of the unique aspects of the biology of the developing child clearly began in the 1800's, pediatrics did not evolve as an independent intellectual and clinical discipline until the 1900's. Since then, this relative newcomer to both the clinic and the research laboratory has begun to bear considerable fruit. Identification of the gene defects responsible for metabolic and degenerative diseases and new models for care delivery and preventive medicine in inner cities are examples of contributions of pediatric research to the body of knowledge that spans the gap between the clinic and the basic science laboratory. However, increasing emphasis on revenue generation, care for those who constitute the taxpaying and voting workforce, and repayment of medical school debt have made it increasingly difficult to attract, foster, and maintain a cadre of individuals whose interests are in the development of a translational body of pediatric knowledge and the dialogue between the laboratory bench and the pediatric clinic and community. It is absolutely vital that we establish and nurture venues in which to train researchers at the interfaces between developmental biology and clinical practice and between the academic sector and the community. The present application proposes to take advantage of the high quality, interactive, and interdisciplinary faculty and environment of the University of Rochester to give clinically trained fellows the opportunity to engage in and understand basic, clinical, and/or translational research, develop in these fellows the thinking skills and knowledge base that will allow their application of basic biological principles towards enhancing and developing our understanding of the developmental origins and mechanisms of chronic disease throughout the lifespan. As the productive lifespan of individuals with childhood diseases increases and as our population ages, this understanding becomes crucial to development of preventive and severity-limiting strategies for human disease. PUBLIC HEALTH RELEVANCE: The proposed program will train clinically oriented fellows in research that bridges between laboratory bench and patient bedside and between patient bedside and community. This research will be aimed at understanding the childhood antecedents of chronic disease across the lifespan - a critical emphasis as our population ages and as children with previously life-threatening diseases can now live into productive adulthood.